Facility Guidelines Institute

Acoustic comfort is a welcome concept for the design and management of healthcare facilities, potentially providing methods to address acoustic environment deficiencies revealed by experience and by the Affordable Care Act’s CAHPS® Hospital Survey, on which the noise question historically performs worst yielding public disclosure and financial penalties to hospitals. One possible vehicle for introducing quantified acoustic comfort into buildings is the healthcare design guidelines published by the Facility Guidelines Institute (FGI), which are adopted as building code in a majority of the United States, provide reference standards for the Leadership in Energy and Environmental Design (LEED) Rating System and the International Green Construction Code, and are cited in 87 countries. For acceptance into the FGI guidelines, “acoustic comfort” requires a formal definition accepted by standards organizations and clinical research, which is free from conflicts of interest based on research conducted by recognized third-party organizations on the physiological and psychological effects of noise on humans, particularly those with compromised health, like patients in hospitals and skilled nursing facilities. FGI encourages proposals from the public, particularly valuing advice from members of professional societies, and relies on the research community to provide evidence-based support for all acoustics topics.

Large tactical teams must demonstrate integrative performance as tens to thousands of operators perform within highly dynamic, complex, and unpredictable environments. The development of methods for capturing integrated performance and the achievement of team goals, while also allowing for and even embracing adaptive performance, is challenging. However, as Distributed Mission Training (DMT) systems continue to mature and are increasingly representative of important training opportunities in the military, diagnostic performance assessment systems are needed to ensure training quality. In this paper, we propose a methodological framework for team performance that is responsive to the performance measurement challenges found within DMT systems. The approach is illustrated within a U.S. Navy research and development program called Debriefing Distributed Simulation-Based Exercises (DDSBE).